Lead Poisoning

What Is It?

Lead is a metal that is poisonous (toxic) when inhaled or eaten. Lead gets into the bloodstream. It is stored in the organs, tissues, bones and teeth.

With increasing or prolonged exposure, lead can cause:

Permanent damage to the central nervous system, especially the brain

Delayed development in children

Behavioral changes in children

Decreased production of red blood cells (anemia)

Hearing problems

Damage to the reproductive systems of men and women

Kidney disease

Convulsions (seizures)

Coma

The leading source of exposure to lead is lead-based paint. This was outlawed for residential use in 1978. But it remains in some older homes. The main hazard is paint dust. Paint dust enters the air when old paint is scraped, sanded or begins to flake.

People can get lead into their bodies in other ways. These include:

Drinking water from pipes that are made of lead or use lead solder

Using ceramic dishes made with lead

Using products made with lead-containing paint (often imported from other countries)

Children face the most serious risk. Their growing bodies absorb more lead. Young children, especially toddlers, tend to put objects in their mouths that may be covered with lead dust. If lead paint is flaking, small children sometimes eat the sweet tasting paint chips. Or they chew on painted surfaces, such as window sills.

Adults who have high lead levels in their blood usually were exposed in the workplace. Industries with a high potential for exposure include:

Construction that involves welding, cutting, blasting or other disturbances of surfaces painted with lead

Smelter operations

Radiator repair shops

Firing ranges

Young children can be exposed to lead when parents who work in these areas carry lead dust home on their clothes and shoes.

A woman who had lead poisoning can pass lead on to her fetus if she becomes pregnant. This remains true even if she no longer is exposed to lead.

Since lead was banned in gasoline and residential paint, average blood levels of lead have dropped dramatically in the United States.

In children, lead levels of 5 micrograms or more per deciliter (mcg/dL) of blood are known to be hazardous. Recent studies suggest that even lower levels may be harmful. Pediatricians closely monitor children whose lead level is approaching 5 (mcg/dL). They are encouraged to look carefully for possible sources of lead exposure.

Symptoms

Children with blood lead levels of 5–25 mcg/dL usually do not show any obvious symptoms of too much lead in the body. The damage may not be obvious. It only becomes noticeable at school age, when the child shows signs of possible learning disabilities, behavioral problems or mental retardation.

At higher exposures, children may experience:

Decreased production of red blood cells (anemia)

Tiredness and fatigue

Headaches

Severe abdominal pain and cramps

Hearing problems

Slowed growth

Persistent vomiting

Convulsions

Coma

Adults with blood lead levels of 40–50 mcg/dL may display some of the same symptoms, or any of the following:

Inability to sleep

Memory and concentration problems

Infertility

Kidney damage

High blood pressure

In pregnant women:

Stillbirths

Miscarriages

Premature births

Problems in fetal neurological development

Diagnosis

A doctor who thinks someone has lead poisoning will do a physical examination. He or she will ask about:

Symptoms

Medical history

Potential environmental exposure to lead

Diet

Any learning or behavior problems (in children)

Lead poisoning is diagnosed with a simple blood test.

Blood tests can also be used for lead screening. Because there are often no early symptoms, a blood test is the best way to identify children at risk of lead poisoning at an early stage.

Lead screening typically starts at age 6 months to 12 months. Lead screening guidelines vary from state to state, but the minimum screening is at 1 and 2 years. The CDC and the American Academy of Pediatrics recommend that children under age 6 be tested for lead if they:

Live in or regularly visit a house or day care center built before 1950

Live in or regularly visit a house built before 1978 that has been remodeled in the last six months

Have a brother, sister, house mate or playmate who is being treated for lead poisoning

Live with a parent whose job or hobby involves exposure to lead

Live near an active smelter, battery recycling plant or other industry likely to release lead into the air

Expected Duration

It may take several weeks, months or years for lead to leave the body, even after there is no further exposure.

Prevention

To prevent lead poisoning, avoid or minimize exposure to lead. Remove lead paint or contain it with frequent cleaning:

Careful and frequent cleaning has been shown to reduce exposure to lead substantially.

Use a mop or sponge with warm water and an all-purpose cleaner to regularly clean floors and other surfaces.

Frequently wash a child's hands, toys and pacifiers with soap and water.

If you have lead paint in your home, do not try to remove it or paint over it yourself. Improper removal of lead paint can make contamination worse by sending lead-containing dust into the air.

Hire a professional trained in lead abatement techniques.

If you have lead pipes or lead solder in your plumbing, or if you have an older house and are not sure about the pipes, call your local health department or water supplier for information on getting your water tested.

Meanwhile, use only cold water for drinking, cooking and for making baby formula.

Run the water for 15 seconds to 30 seconds before drinking it, especially if you have not used the water from that faucet for a few hours.

If your job involves potential lead exposure:

Insist that your employer comply with all federal and state laws to protect workers and to monitor their health.

Launder your work clothes separately from those of the rest of the family or from clothes you do not wear for work.

For more information on sources of lead poisoning and ways to prevent them, visit the Lead website at the Centers for Disease Control, www.cdc.gov/nceh/lead.

Treatment

For all cases of lead exposure, the most important step is to remove the source of lead. When this is done, treatment is not usually necessary if the blood lead level is less than 20 mcg/dL. However, repeat blood tests to be sure the amount of lead in the bloodstream stays low.

Higher levels of lead in the bloodstream may need to be treated. Treatment consists of taking a drug that binds to the lead and helps the body to remove it. This process is called chelation therapy.

Doctors decide whether to use chelation therapy on a case-by-case basis. Very high levels of lead (70 mcg/dL or greater) sometimes require hospitalization to begin therapy.

After treatment and/or removal of the environmental lead source, the doctor normally will do more blood lead tests. Blood tests help track blood levels until they are no longer too high.

Besides recommending a nutritious diet, the doctor also may recommend iron or calcium supplements. If a child with lead poisoning has iron-deficiency anemia, it is very important that the anemia be treated. Anemia puts the child at higher risk.

When To Call a Professional

If you are the parent or guardian of a child under age 6, make sure he or she visits a health professional regularly. Discuss possible risks of lead poisoning with the doctor have your child get tested if necessary.

See the child's doctor immediately if you notice symptoms of lead poisoning or suspect that the child has been exposed to lead.

Prognosis

The outlook for children with lead poisoning depends on:

The amount of lead in the body

How long the child was exposed

How the child responded to treatment

Children with brief, low-level exposures usually recover completely. Many children with low to moderate lead exposure for prolonged periods have decreased intellectual function. Even with appropriate treatment, children with high levels of blood lead can have severe, irreversible brain damage.

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